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Trend of nocturnal enuresis in children with attention deficit/hyperactivity disorder: a nationwide population-based study in Taiwan
  1. Jeng-Dau Tsai1,2,
  2. I-Chung Wang3,
  3. Hsuan-Ju Chen4,5,
  4. Ji-Nan Sheu1,2,
  5. Tsai-Chung Li6,7,
  6. Henry J Tsai8,
  7. Chang-Ching Wei3,5
  1. 1School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  2. 2Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
  3. 3Children's Hospital of China Medical University Hospital, Taichung, Taiwan
  4. 4Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  5. 5College of Medicine, China Medical University, Taichung, Taiwan
  6. 6Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
  7. 7Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan
  8. 8Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
  1. Correspondence to Dr Chang-Ching Wei, Children's Hospital of China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, No2, Yu-Der Road, Taichung 40402, Taiwan; weilonger{at}


Attention-deficit/hyperactivity disorder (ADHD) and nocturnal enuresis are common disorders with extensive psychosocial suffering in affected children, and healthcare burden on parents. Whether the childhood psychological disorders and nocturnal enuresis are factors contributing to ADHD have not been clearly established. This study conducted a population-based case–control study using data sets from the National Health Research Insurance database, and identified 14 900 children diagnosed with ADHD. Risk factors that have been associated with or possibly related to ADHD development were included in this study. Performance of in groups of ADHD with enuresis was compared with controls. With adjustment for potential covariates, participants with enuresis exhibited a 2.24-fold greater risk of subsequent ADHD development compared with controls (95% CI 1.84 to 2.73). Participants with enuresis and comorbidity had a significantly greater risk of ADHD than those with no enuresis and no comorbidity (adjusted OR=8.43, 95% CI 4.38 to 16.2). Children who are assessed for ADHD should be evaluated for the presence of enuresis or other neurobehavioral comorbidities. Multidisciplinary treatment may benefit children with ADHD and minimize psychological burden on parents.

  • Nervous System Diseases
  • Comorbidity

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  • Contributors I-CW and J-DT drafted the initial manuscript, and approved the final manuscript as submitted. H-JC and T-CL carried out the initial analysis, reviewed and revised the manuscript, and approved the final manuscript as submitted. C-CW coordinated and supervised data collection, critically reviewed the manuscript, and approved the final manuscript as submitted.

  • Funding The study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039–005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan, the Bureau of Health Promotion, Department of Health, R.O.C. (Taiwan) (DOH99-HP-1205).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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